The 7D's of Stroke Care

Use the 7 D's mnemonic to remember key points in the management of the stroke patient:

1. Detection
2. Dispatch
3. Delivery
4. Door
5. Data
6. Decision
7. Drug

Delay may occur at any of these points of management, so at each point, response to and management of the stroke victim may be skilled and efficient.

The first 3D's are the responsibility of the community, including the lay public, first responders and EMS responders.

Detection- detection occurs when a patient, family member, or bystander recognizes the signs and symptoms of a stroke or TIA and phones the emergency response number 911

Dispatch - EMS dispatchers must then prioritize the call for a suspected stroke patient as they would a victim of heart attack or serious trauma and dispatch the appropriate EMS team with high response priority.

Delivery - EMS providers must respond quickly, use a rapid prehospital stroke screening toll to identify the signs and symptoms of a suspected stroke, provide prearrival notification to the receiving hospital and transport the patient to a hospital capable of caring for patients with acute stroke. EMS providers should consider transporting the victim's relative or family member to confirm the time of symptom onset. The receiving hospital will rapidly evaluate the patients with acute stroke. EMS providers should consider transporting the victim's relative or family member to confirm the time of symptom onset. The receiving hospital will rapidly evaluate the patient, determine eligibility for fibrinolytics and provide fibrinolytic therapy within 3 hours of the onset of stroke symptoms

The last 4 D's are initiated in the hospital

Door - Initial emergency department triage and evaluation

Data - Acquiring a CT scan to diagnose the absence of hemorrhage in the brain

Decision - Identifying candidates eligible for fibrinolytic theraphy

Drug - Treating with fibrinolytic thera

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